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Pain in shoulder, viral gastroenteritis. CX spine MRI done. What is the treatment?

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Orthopaedic Surgeon
Practicing since : 2000
Answered : 170 Questions
Dear Sir,
I want your advice on my left shoulder ailment. I had a pain in my let shoulder when I was admitted in a hospital during 1st week of March for Viral Gastroenteritis and I had shown to an Otho doctor and he said no problems. First week of this month I have noticed some kind of muscle wasting and I went to a nearby ortho surgeon. As per his advice I have taken my CX spine MRI done (report attached for your kind information) After seeing the report he told me that nothing can be done and this will remain as it is. Pls advise me if there is any treatment for this kind of ailments

Thanks & regards,

Posted Mon, 16 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Atul Wankhede 7 hours later
Thanks for choosing XXXXXXX for your query.

As your orthopaedician must have told you, it looks like a radicular pain radiating from a compressed nerve root (namely C6 & C7) in your cervical spine. I'm sure that he must have examined your shoulder first in order to rule out any intra articular pathology. By which I broadly mean that we have to be absolutely sure that the shoulder per se is normal from with in and the pain is originating from elsewhere, mostly from cervical spine. The other symptom you noted is weakness and wasting of muscles again confirms possibility of nerve involvement.

Your MRI too confirms a wide degenerative changes quite abnormal for your age. The disc dessication at almost all levels is shocking. At this stage the line of treatment is decided very meticulously. The conservative line of treatment will be in form of rest, anti inflammatory medications, nerve tonics, cervical collar and most importantly physiotherapy in form of local ultra sonics/TENS, cervical traction and neck isometric and shoulder strengthening exercises.

This if done properly should help relieve the symptoms soon. If not, surgical intervention will be imperative. Surgery is required if persistent pressure over the nerve root causes loss of function of the muscles it innervates and sensations it gives to a part of skin.

Lets not worry about that just yet. Lets give conservative treatment the best shot. Please feel free to ask more if you need to know more on any particular issue, I'm available for follow up.
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Follow-up: Pain in shoulder, viral gastroenteritis. CX spine MRI done. What is the treatment? 14 hours later
Dear Sir,
Thanks for your reply/ i also want to share the NCV and EMG report with you so that you will get more details. Please find attached report

thanks & regards,

Answered by Dr. Atul Wankhede 40 minutes later
Thanks for replying back with report.

Your NCV is more than helpful in confirming the chronicity of nerve pathology. As it shows partial denervation of C5-6 nerve root of chronic duration, there is absolutely no doubt of this being your cervical spine abnormality.

In my opinion, as discussed previously you must give conservative modalities a chance and also be alert of any worsening of pre existing symptoms which warrant immediate decompressive surgery.

Above answer was peer-reviewed by
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